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ECLA ERF
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Grant Application Form
Date
*
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Month
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Day
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Year
Year
2024
2025
2026
date of submission
Title of Research Proposal
*
title of research proposal
Position
*
position
Principal Investigator
*
principal investigator
Street Address
*
City
*
State
*
Zipcode
*
Telephone
*
Fax
Email Address
*
Scientific Supervisor
*
Supervisor Position
*
Supervisor Street Address
*
Supervisor City
*
Supervisor State
*
Supervisor Zipcode
*
Supervisor Telephone
*
Supervisor Email Address
*
Co Investigators
Organization to which award should be made
Organization Street Address
Organization City
Organization State
Organization Zipcode
Organization Telephone
Organization Email Address
Total Budget Request
Agreement
If the project is approved for support, I agree to provide interim reports as required and a project report and financial statement at the completion of the award duration. I agree to return to the ECLA/CLAO ERF any unexpended funds. I agree to acknowledge support of the ECLA/CLAO ERF in all publications resulting from this grant. I have not applied nor have been awarded governmental or philanthropic funding to carry out this project. NOTE: It is the policy of the ECLA/CLAO ERF not to pay indirect costs.
Aim: State the specific aim(s) of this study.
Previous Studies: Summarize previous studies related to this project.
Significance: What is the significance of this study to contact lens science and/or ocular anterior segment science?
Research Plan: Provide a concise description of the methodology to be used. Relate the research techniques directly to the specific aim(s).
Qualifications: What are your qualifications to carry out this study?
Facilities: What facilities do you have to carry out this study? List responsibilities of key personnel pertaining to this study.
Other Funding: What other funds do you have to assist in the completion of this study (e.g. technician support, equipment, etc.)? List all grant applications pertinent to this study that are currently submitted or planned within the next year.
Budget: Itemize and total all proposed expenditures; provide a brief justification for any item for which the need may not be obvious. Please include personnel, equipment (not to exceed maximum allowed), supplies (including cost per individual item), and
